Arthroscopic repair of anteroinferior glenoid rim fractures: mean 10-year clinical and radiologic results

Abstract

Background: To date, long-term results of the arthroscopic repair of glenoid rim fractures are missing. The aim of this study was, to evaluate clinical and radiographic results following arthroscopic repair of anteroinferior glenoid fractures using anchors or bioabsorbable compression screws after a mean follow-up period of 10 years.

Methods: Clinical outcome measures included evaluation of recurrent instability, the Constant Score, Subjective Shoulder Value, Rowe Score (RS), Western Ontario Shoulder Instability Score, and Melbourne Instability Shoulder Score. X-ray images were obtained for assessment of an instability arthropathy (IA).

Results: Twenty-three patients (7 female and 16 male, mean (±standard deviation) age 48 ± 15 years) who underwent arthroscopic repair of an acute substantial solitary or multifragmented anteroinferior glenoid rim fracture were enrolled. After a mean follow-up period of 10 ± 2 years, patients reached a mean Constant Score of 92 ± 10 points, Subjective Shoulder Value of 93 ± 11%, RS of 84 ± 20 points, Western Ontario Shoulder Instability Score of 98 ± 2%, and Melbourne Instability Shoulder Score of 91 ± 11 points. No patient suffered recurrent dislocation. Radiographic results were obtained of 18 patients. Signs of IA were noted in 9 patients (50%) with progression of IA in all cases in comparison to the preoperative status. Patients with IA were significantly older (52 vs. 38 years, P = .04). Clinical score results did not show a significant difference in patients with vs. without IA except for the RS (74 vs. 94 points, P = .02). No intraoperative or postoperative complications were observed, and no patient required revision endoprosthetic surgery.

Conclusion: Arthroscopic repair of acute anteroinferior glenoid rim fractures shows good clinical long-term results. High rates of IA were observed especially in older patients. However, the presence of IA did not seem to influence the subjective shoulder score outcomes.

Keywords: Anteroinferior glenoid rim fractures; Shoulder arthroscopy; arthroscopic repair; long-term results; shoulder instability; shoulder stabilization surgery.